Outbreak of Lassa fever in Nigeria

Press Release by the Hon Minister of Health, Federal Republic of Nigeria – Prof. Isaac F. Adewole on 6th January, 2016

Outbreak of Lassa fever in Nigeria:

In the last 6 weeks Nigeria has been experiencing Lassa fever (LF) outbreak which has so far affected 8 states. The States affected include Bauchi, Nassarawa, Niger, Taraba, Kano, Rivers, Edo and Oyo States. The total number of suspected cases so far reported is 76 with 35 deaths, and a Case Fatality Rate (CFR) of 46%. Our laboratories have confirmed14 cases, indicative of a new episode of Lassa fever outbreak.

The first case of the current outbreak was reported from Bauchi in November, 2015. This was followed by cases reported by Kano State, and subsequently the other states mentioned above.

Lassa fever is an acute febrile illness, with bleeding and death in severe cases, caused by the Lassa fever virus with an incubation period of 6-21 days. About 80% of human infections are asymptomatic; the remaining cases have severe multi-system disease, where the virus affects several organs in the body, such as the liver, spleen and kidneys.

The onset of the disease is usually gradual, starting with fever, general weakness, and malaise followed by headache, sore throat, muscle pain, chest pain, nausea, vomiting, diarrhoea, cough, and bleeding from mouth, nose, vagina or gastrointestinal tract, and low blood pressure.

The reservoir or host of the Lassa virus is the “multimammate rat” called Mastomys natalensis which has many breasts and lives in the bush and peri-residential areas.

The virus is shed in the urine and droppings of the rats hence can be transmitted through direct contact, touching objects or eating food contaminated with these materials or through cuts or sores. Nosocomial transmission also occurs in health facilities where infection prevention and control practices are not observed. Person to person transmission also occurs most especially when a person comes in contact with the virus in the blood, tissue, secretions or excrements of an infected individual.

In response to these reported outbreaks, my Ministry has taken the following measures to curtail further spread and reduce mortality among those affected:
i. Immediate release of adequate quantities of ribavirin, the specific antiviral drug for Lassa fever to all the affected states for prompt and adequate treatment of cases.

ii. Deployment of rapid response teams from the Ministry to all the affected states to assist in investigating and verifying the cases and tracing of contacts.
iii. Clinicians and relevant healthcare workers sensitized and mobilized in areas of patient management and care in the affected states.

hiv. Affected States have been advised to intensify awareness creation on the signs and symptoms and general hygiene.

Furthermore, it is important to note that Nigeria has the capability to diagnose Lassa fever and all the cases reported so far were confirmed by our laboratories. However, because the symptoms of Lassa fever are so varied and non-specific, clinical diagnosis is often difficult, especially early in the course of the disease.

In view of the major steps taken so far:
1. All health facilities in the country are hereby directed to emphasize routine
infection prevention and control measures and ensure all patients are treated
2. Family members and health care workers are advised to always be careful to avoid contact with blood and body fluids while caring for sick persons.
3. No travel restrictions will be imposed from and to areas currently affected.
4. Healthcare workers seeing a patient suspected to have Lassa fever should immediately contact the State Epidemiologist in the state ministry of health or call the Federal Ministry of Health using the following numbers: 08093810105, 08163215251, 08031571667 and 08135050005.

• The World Health Organization (WHO) is being notified of the cases confirmed and I wish to seize this opportunity to express my sincere gratitude to the WHO and other partners for the support so far.

The Nigeria Centre for Disease Control (NCDC) is already coordinating all our response activities and reporting to me on daily basis.

The Nigerian Government will continue to enhance its surveillance and social health education, information and communication activities to prevent the disease from spreading further in Nigeria and I wish to call for the support and understanding of all Nigerians.

I thank you all